Am J Psychiatry 1991; 148:606-611
Copyright © 1991 by American Psychiatric Association
European versus U.S. data on the course of schizophrenia
J Marengo, M Harrow, J Sands and C Galloway
Department of Psychiatry, Northwestern University Medical School, Michael Reese Hospital and Medical Center, Chicago, IL.
OBJECTIVE: The present research attempts to add to the existing body of
data on the course of schizophrenia by comparing the findings of a
prospective study of a group of U.S. schizophrenic patients with data from
two European studies. METHOD: Seventy-four U.S. patients given the
diagnosis of schizophrenia according to Research Diagnostic Criteria were
longitudinally assessed at hospitalization and at three intervals up to 10
years after illness onset. The longitudinal criteria for type of onset,
course of illness, and outcome were derived from the European studies of
Manfred Bleuler and Luc Ciompi. The type of onset, course of illness, and
outcome of the U.S. patients were compared with those of the patients in
the two European studies. RESULTS: A lower rate of acute onset and of
episodic illness was found in the U.S. patients, but the relative frequency
of a number of major overall course patterns was similar across studies.
CONCLUSIONS: Despite many potential threats to comparability, the results
of the European and U.S. longitudinal studies of the course of
schizophrenia were fairly congruent in terms of the relative rate with
which patients fell into the categories established by Bleuler and Ciompi.
These results are encouraging in that they point to the possibility of
estimating the rate of occurrence of particular expressions of the overall
course of schizophrenia.
